If the "no preexisting conditions" language IS taken out of the HRC, is there anything good left in?

[Ken Burch]

If that did happen, wouldn't the only decent thing be to admit that what remained couldn't even be WORTH passing, since there'd be no gains for the people at all?

[saracat]

1. Even as it stands the PrEX clause already has ways around it built into it.

This HCR is just about worthless and is about to give employers the worlds greatest excuse to not provide coverage. Paying the fine will be so much cheaper!

[ixion]

10. exactly...

I've heard many people use the PrEx as a rationale, all the while failing to mention that all the insurance company has to do is claim fraud (easy enough to do with a pre-existing condition) and presto!

Worse yet, I'm sure they'll share this 'fraud' information with other insurance companies, making it next-to-impossible to actually get coverage, in which case you get fined.

The real fraud is this ludicrous piece of legislation.

[Ms. Toad]

13. Fraud wouldn't work

If they have to both offer insurance and cover pre-existing conditions, the insurance company cannot have relied on the (mis)representation to its detriment. (That's an element that the insurance company would need to establish in order to prove fraud).

Obtaining coverage by lying about (or inadvertently forgetting) medical issues when the insurance company would have been required to issue at the same price if your information had been absolutely truthful and complete cannot satisfy the legal standards for proving fraud.

[saracat]

21. Iwasn't referring to fraud. I was thinking about high risk pools for which the companies would

increase premiums. They wouldn't decline coverage.They would price it out.Without aPO , there are no price conrols in this bill. Without a PO there is no governemnt competition forceing lower rates. They can all raise their rates and we will have no choice but to purchase it or pay a fine.And that will be the choice for all but a very few.

[Ms. Toad]

22. The bills eliminate high risk pools.

(at least once it is fully implemented - I am still annoyed that they are delaying implementation of the crucial features of the bill for a number of years.) But - aside from variation do to age (and a handful of directly controllable health risks like smoking), the insurance companies must offer the same plan to all applicants at the same price. You don't get placed in a plan based on your health. That means omitting something from your application (even if those question are still on the application) would not have made the difference between being in a high risk pool or not - everyone is in the same pool.

There are price controls in the bill - one direct and one indirect. First, there is a direct price control because 80%-85% of the premiums must be paid out as benefits (depending on whether senate or house version passes). That limits the amount that can be paid to employees or taken out as profit to no more than 20%. Second everyone is in the pool, so the costs are averaged over the entire pool (either state or federal, depending on which version survives the reconciliation). That does mean that people who have not been purchasing insurance - or were purchasing it as young healthy people will be paying more, but anyone with any seriously health condition who is not already part of a large pool will be paying less. Using the actual cost of care from Canada, and the price limitations in the bill, that should put the premiums in the ballpark of $5000-$7000 per year. That's a darn sight better than anyone in a high risk pool can find now. If we did not have insurance through work, my daughter's premium at age 19 would be $14,000 - mine at age 50+, mine would be close to $50,000.

[BzaDem]

2. That language isn't going anywhere.

There is language that allows people to pay 20-30% less depending on certain health factors (meant to have an incentive for healthy choices). This is problematic, as insurance companies may be able to use this to raise some peoples' rates behind the back door. This language will probably be changed (and the premium variation allowed reduced).

But this is still a HUGE change from the current market, where insurance companies can and do charge 1000%+ (and sometimes much more) for people who have pre-existing conditions. Such premium variation makes insurance unaffordable for almost anyone with such a condition, which ends up causing a large portion of bankruptcies.

In addition to the pre-existing condition discrimination ban, there are also over 500 billion dollars to help poor and middle income people get required-benefit-package, required-actuarial-value health insurance from profit-regulated companies. In a normal year, this would be considered one of the biggest expansions of the social safety net since Medicare itself, though in these times people seem to like equating this to a "corporate bailout." In addition to these subsidies, the bill contains the biggest expansion of Medicaid since its inception (which will now be available to anyone in any state at 133% of the poverty level or below).

[flyarm]

3. and the guy Obama has working on this has no credibility! and is being exposed having huge conflicts

and has not disclosed his experise AND OPINIONS were being "BOUGHT" WITH YOUR TAX DOLLARS!

oh and about our wages going up with lower$$$ health care packages..more bullshit..pure bullshit..

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

emptywheel January 7th, 2010 at 9:09 pm
7
In response to WilliamOckham @ 1

Actually, the problem is much greater than that. People have repeatedly used Gruber’s work to support arguments that they don’t actually support (his only “proof” that the excise tax will raise wages is a study on how employers raise wages on non-fertile women after maternity care is mandated, and on that EVERYONE has based their claims).

So you have to ask–did a bunch of “intelligent” people just lose all their critical thinking skills? Or is someone feeding a bunch of other nominally independent “journalists” Gruber’s claims, and they’re publishing it for some reason or another?

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

and don't think for a minute the Unions don't know this info!!!!!!!

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

Follow the Money: Your Tax Dollars Bought Jonathan Gruber’s Services
By: Rayne Sunday January 10, 2010 10:30 am http://seminal.firedoglake.com/diary/23174

Firedoglake has been researching the relationship of MIT economist Jonathan Gruber with the Obama administration with regard to health care reform. You’ll find posts by emptywheel, dday and Jon Walker about the apparent conflicts of interest on Gruber’s part, that of the Obama administration and the media covering health care reform.

We’re still looking at the money – yes, follow the money, as Deep Throat once said – paid out to Gruber by the government. OUR MONEY, our tax dollars, paid out to Gruber under three administrations. You can view the numbers at this link, at which you’ll find a published spreadsheet with all information compiled from USASpending.gov and NIH websites (links to sources at the end of this post).

But there are more questions after looking at the data; perhaps the answers are innocuous and amount to nothing, but it would certainly be nice to have some answers.

What permits Gruber to be offered “non-compete” contracts?

What does it mean that a substantive number of the contracts offered to Gruber were let under classification, “Available only for groups such as disabled persons, prisoners, and regulated utilities”?

Why does Gruber have two business identities documented by two DUNS numbers, one of which is a nonprofit entity?

Why are the 2009 contracts for HHS paid to the nonprofit?

Why are there so many fields with “invalid” content or no content where one would reasonably expect some information?

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

edit to add: please take the time to read the comments section..much is disclosed here that should make every American suspect to what is going on!

xxxxxxxxxxxxxxxxxxxxxxxxxxxx

Jonathan Gruber Failed to Disclose His $392,600 Contracts with HHS (Updated)
By: emptywheel Thursday January 7, 2010 8:35 pm
http://emptywheel.firedoglake.com/2010/01/07/jonathan-g... /

MIT health economist Jonathan Gruber has been the go-to source that all the health care bill apologists point to to defend otherwise dubious arguments. But he has consistently failed to disclose that he has had a sole-source contract with the Department of Health and Human Services since June 19, 2009 to consult on the “President’s health reform proposal.”

He is one source for the claim that the excise tax will result in raises for workers (though his underlying study is in-apt to the excise tax question). He is the basis for the argument that the Senate bill reduces families’ risk–even if it remains totally unaffordable. Even Politico stenographer Mike Allen points to Gruber’s research.

But none of the references to Gruber I’ve seen have revealed that Gruber has a $297,600 contract with HHS to produce,

a technical memorandum on the estimated changes in health insurance coverage and associated costs and impacts to the government under alternative specifications of health system reform. The requirement includes developing estimates of various health reform proposals on health insurance coverage and cost. The alternative specifications to be considered will be derived from the President’s health reform proposal.

(h/t Mote Dai)

The President’s health reform proposal? But I thought this was the Senate’s health reform proposal?!?!? (wink!)

Now, HHS says they had to put Dr. Gruber in charge of evaluating health care reform proposals because he’s got,



go to link to read the rest!!!

but note in comments section..Emptywheels comment here:

emptywheel January 7th, 2010 at 9:09 pm
7
In response to WilliamOckham @ 1
Actually, the problem is much greater than that. People have repeatedly used Gruber’s work to support arguments that they don’t actually support (his only “proof” that the excise tax will raise wages is a study on how employers raise wages on non-fertile women after maternity care is mandated, and on that EVERYONE has based their claims).

So you have to ask–did a bunch of “intelligent” people just lose all their critical thinking skills? Or is someone feeding a bunch of other nominally independent “journalists” Gruber’s claims, and they’re publishing it for some reason or another?

[Jim Sagle]

4. I'll take "No" for fifty cent, Alex.

[flyarm]

5. there is nothing good for "we the people" and we have been lied to over and over again

http://www.youtube.com/watch?v=I8wmN3wvhNM&feature=player_embedded


http://www.youtube.com/watch?v=8pO1oJPps1I&feature=player_embedded

[Bluebear]

6. Not only good, but spectacular! For the insurance industry.

[flyarm]

7. it is all a scam!!

do read the comments!!

Gruber’s Response: “Consistent” but Not “Disclosed”
By: emptywheel Friday January 8, 2010 6:47 am



http://emptywheel.firedoglake.com/2010/01/08/grubers-response-consistent-but-not-disclosed/

Ben Smith got a fairly long response from Jonathan Gruber on why he hasn’t disclosed the $392,600 contracts he has had with HHS during the period when he was the chief spokesperson for the Administration’s health care plan. He lays out his qualifications and points to some studies addressing the questions I have asked (I’ll return to them shortly). The bulk of his response is spent insisting that everything he has said was completely consistent with his beliefs (which, if I remember correctly, is just what Armstrong Williams had to say).

Moreover, at no time have I publicly advocated a position that I did not firmly believe – indeed, I have been completely consistent with my academic track record. On the two issues this article raises:

But that, of course, wasn’t the point. I don’t doubt he believes all this stuff. But why didn’t he disclose it? Here’s what he says about that.

Gruber told POLITICO that he has told reporters of the contract “whenever they asked” and noted that he formally disclosed that “I am a paid consultant to the Obama Administration” in a form attached to his most recent, December 24 article in the New England Journal of Medicine, though it wasn’t widely known by reporters on the beat.

So, nine months after he first gets a contract with HHS, he starts disclosing the relationship, and only to the organization that can totally discredit him professionally, not to those that will more directly affect the health care debate? Gruber was first put under contract in March of last year–$95,000 to promote “the President’s” plan–and the received another $297,600 in June. Why no disclosure then? And why–after he decided he ought to start disclosing this stuff–did he not disclose it in a December 28 op-ed in the WaPo?

[MadHound]

8. There is not enough in this bill, even with the language, for any self respecting liberal to support

We need to kill this bill now, but that's probably not going to happen.

Another instance of we the people getting bipartisanly screwed.

[chimpymustgo]

11. "not enough in this bill...for any self respecting liberal to support"

[DailyGrind51]

9. HCR becomes totally useless!

[stray cat]

12. If you are near poverty you get free health insurance or Medicaid

If your self-employed you can bargain in groups like a larger employer. Of course there are good things- the question becomes and always was if the good outweighs the bad. Anything else is too simplistic.

[Odin2005]

14. Nope!

[freddie mertz]

15. No. It 's probably too late to get anything good out of this bill.

What a boondoggle this has been.

[JVS]

16. It's becoming pretty clear that this bill isn't about the citizens, it's about saving the industry

The industry cannot survive the boomers going to medicare and the younger underpaid generation not having the wealth to buy insurance

[Lydia Leftcoast]

17. Are they actually considering that?

Well, then it couldn't be clearer.

This isn't the Healthy Americans Act.

This is the Backdoor Bailout for the Insurance Industry Act.

[Kansas Wyatt]

18. I've been saying Kill the HCR/DLC Bill for months now...

Slowly people are waking up to what this HCR/DLC Bill is all about...

Nothing for the American People and a BIG GIVEAWAY to the Insurance Industry. And they are penalizing Unions with it now as well! FDR must be rolling over in his grave, with what the Democratic Party is doing today.

With today's Democrats:

Their idea for Social Security, would be slavery to the Company Store until death.

They are a fucking disgrace!

[Nite Owl]

19. It's not worth anything

even now.

[Tim01]

20. Higher taxes and forced purchace of insurance. Thats it.

Nothing good for anybody but the insurance companies. We are fucked,by this bill, and by those trying to pass this bill.